HOUSE OF HEARINGS

Medical Marketing and Media, Dec 2006 by Arnold, Matthew

With the Democrats set to take control of Congress, the new guard of committee leadership presents a mixed-to-bleak picture for pharma industry interests.

Hearings, hearings and more hearings on the dastardly doings of the pharmaceutical industry will be the order of the day for a Democratic Congress, Washington insiders say.

While congressional Dems may not have the votes to overcome a fili-buster or a presidential veto, they do have the gavels-and the subpoena powers that go with it. Pharma foes like Ted Kennedy, Henry Waxman and Pete Stark can use their committee assignments to direct a litany of inquiries-into drug pricing, reimportation, the use of physician data by drug companies and pharmaceutical promotion, to name just a few hot-button issues concerning prescription drugs. Incoming House Speaker Nancy Pelosi has promised to empower Health and Human Services to negotiate drug prices directly with companies in her first 100 hours at the podium.

Practically, all this may amount to bupkus. The Democrats don't control Health and Human Services-the President does. They are far short of the 291 votes in the House and 67 votes in the Senate needed to override a presidential veto, even if they can pick off a few Republicans.

The Dems do have a powerful pulpit from which to bully some of their favorite nemeses, and Big Pharma's high on the list. "In Washington, the two industries most strongly viewed as perpetuating GOP rule are oil and pharmaceuticals," says one DC advertising industry insider, who wished to remain anonymous. "Is it payback time? I think so."

As of October 10, pharma political action committees (PACs) and individuals had pumped more than $10 million into GOP coffers for the 2006 election cycle-versus just $4 million for the Dems (though that equation doubtless evened out somewhat in the last weeks of October). That's down from the $18 million drug companies gave to the Republicans in the 2000 election cycle and the $21 million they doled out in 2002, with Medicare Part D on the line.

Then there's public opinion to consider. Pharmaceutical firms have been tacking up from post-Vioxx lows, but still rank uncomfortably close to the oil and tobacco industries in public trust, and that makes them an attractive target for ambitious pols-particularly with a presidential election just around the corner.

"Rather than working together to move forward, the end of the midterms just means the beginning of the 2008 election cycle," says former FDA assistant commissioner for communications Peter Pitts, now director of the Center for Medicine in the Public Interest and SVP, global health affairs at MS&L. "I see more or less the same thing, which is continued bashing of the pharmaceutical industry."

Pharma-bashing could grow more pointed as members seek trophies with which to pave their party's way down Pennsylvania Avenue.

"The job of a committee chairman is to keep their parties in the White House or get them there," says John Kamp, executive director of the Coalition for Healthcare Communications. "In the House, we're going to have a lot of hearings on how things haven't been appropriately handled by the old guys."

To be sure, the Republican hegemony of the past six years hasn't been a cakewalk for the pharmaceutical industry. Despite a major legislative victory with the Medicare prescription drug benefit and the executive branch's general preference for industry self-regulation over a more interventionist approach, bashing Big Pharma remains a bipartisan sport. GOP legislators like Sens. Grassley (R-IA) and Frist (R-TN) have been sharply critical of pharmaceutical pricing and promotion, and Sen. Vitter (R-LA) has lobbied hard for reimportation of drugs from Canada-even placing a hold on the nomination of Andrew von Eschenbach to head the FDA. Together with his Democratic colleague on the Senate Finance Committee, Sen. Max Baucus (D-MT), Grassley has also grilled the industry over grants for medical education.

However, the GOP's pro-business, anti-regulation governing philosophy has benefited the industry as when, in the wake of the Vioxx scandal, with calls for a curb on DTC mounting, PhRMA was able to head off congressional intervention with its Guiding Principles for DTC Advertisements About Prescription Medicines. The Democrats tend to favor a more activist approach to government.

While the Democrats' squeaker capture of the Senate got the big headlines, their victory in the House is probably of greater significance to the drug industry, because it completes the circuit. "In the Senate, the change is going to be a matter of degrees," says the ad industry insider. "The House is another story, because no matter what came out of the Senate, it went nowhere in the House with (former Majority Leader Tom) DeLay and (outgoing Energy and Commerce chair Joe) Barton. So that was a sort of insurance policy."

The players

A particular champion of muscular regulation is Rep. Waxman (D-CA), who will serve as chairman of the House Committee on Government Reform, where he will enjoy virtually unlimited oversight jurisdiction. "He doesn't have an agenda, he has a vendetta," says Pitts. As former chair of and then ranking Democrat on the House Energy and Commerce Committee's Subcommittee on Health, Waxman has been perhaps the leading Democratic advocate on healthcare issues and one of the drug industry's strongest critics in congress. His office is known for its fearsome investigative prowess and mastery of procedure.